PUBLIC HEALTH LEGISLATION AND PROBLEMS IN VICTORIAN EDINBURGH« WITH SPECIAL REFERENCE TO THE WORK OF DR. LITTLEJOHN AS 'MEDICAL OFFICER OF HEALTH A thesis presented by Hector I'acdonald to the University of Edinburgh in candidacy for the degree of Doctor of Philosophy. 1971. This thesis has been composed by myself and represents my own work. SUMMARY This thesis seeks to provide a study of the local public health situation in Edinburgh in Victorian times. While such a study has to cover many topics, contemporary public health legislation provides the key. It represented, up to a point at any rate, contemporary public health thinking; from it action over public health matter was based. The activities of the local M.O.H. are important: the post was a specific creation of the 19th century. In Edinburgh, as elsewhere, there was little consciousness of the need for any permanent public health legislative programme before the 1840's. Though Chadwick's revelations did not hit Edinburgh with the same impact as in English cities, the partial impact of the sanitary literature in circulation and the cumulative effect of severe epidemics meant that the local municipal authorities had by i860 gone some way to meet an increasingly acknowledged need for public health legislation. The great lack was a systematic administering of such legislation and, initially, the appointment of Dr." Littlejohn did not remedy this defect. Not even the authorising of a massive Improvement Scheme, progressive step as it was, did so. When the appointment of the Public Health Committee in 1872 at last did so, machinery existed from which administrative expansion could later be made. The need for this and for legislative extensions was constantly apparent in the 1870*s and l880's, though nearly all topics associated with the 19th century had already received some legislative attention. By the 1890's most contemplated extensions had been made, and the Town Council were following the national pattern in moving into new areas of legislative activity, associated more with the 20th century. Dr. Littlejohn was rarely publicly prominent. His celebrated I865 Report oh the Sanitary Condition of Edinburgh did not have its suggestions all carried out immediately. The credit for neither.the immediate launching nor the execution of the Improvement Scheme lies with him. SUMMARY (cont'd). From 1862 to 1900 he publicly advocated public health legislation very rarely. However, for local public health legislation to evolve, he did not have to be publicly prominent: his mouthpieces on the Town Council and other sanitary officials couldpress his opinions. Further¬ more, his frequent production of health statistics was the justification and guide for public health legislation. When legislation offended some interests, important legislation could be delayed or prevented. However, much important legislation was passed with little or no opposition. Legislation tended to make the recognition of further problems and the need for further legislation more apparent. While early legislation produced only limited results, there were dramatic improvements in public health in the l870's, but, subsequently, legislation failed to achieve much further improvement. With topics, recognised as suitable for public health legislative action, being gradually covered, massive and seemingly insoluble barriers to further improvement loomed up ever more clearly. Vastly extended public health legislation was required: the real problem was that improvement of public health was an endless task. CONTENTS VOLUME Page 1. Introduction 1 2. Slow Growth of Municipal Public Health Consciousness Before Advent of M.O.H. 19 3. Fall of Tenement in High St. in 1861; Appoint¬ ment of Dr. Littlejohn as M.O.H. in 1862. 54 4. Early Work of Dr. Littlejohn and His Celebrated Report on the Sanitary Condition of Edinburgh 69 5« Introduction by Sir William Chambers of Chambers Improvement Scheme, As First Fruits of Dr. Idttlejohn's Report. 93 6. Preparation of Improvement Scheme Plans and Chambers's Struggle to Pilot Plans to Legis¬ lative Stage 108 7. fteview of Chambers Improvement Scheme in ""rogress, and Assessment of Results. 136 8. X Prominence of Sanitary Questions in Public Opinion, and Response of Town Council, 1861-74. 164 9- The Placid Later 1870's and Municipal and Polica Act of 1879. 192 10. Strengths and Weaknesses of Yunicipal Sanitary Administration: Revival of Sanitary Conscious¬ ness, 1879-1891. 216 11. The Frustrating Nineties: An Assessment of Dr. Littlejohn. 242 Appendices 278 Bibliography - 308 VOLUME 1 fl|>f>en dices I No lei on Mm/15 33 Witk j)ocfcet ' insicle buck Cover ABBREVIATIONS .For no. read number For M.O.H. read Kedical Officer of Health For st. read street For J.C. read water-closet For Dr. read Doctor For Rev. read Reverend For P.P. read Parliamentary Papers For rd. read road. "j7hen municipal bodies (or committees of such bodies), or local insti¬ tutions are referred to and no indication is given as to which town such bodies or institutions belong, they shall be taken as belonging to Edinburgh. ■ ■ t PREFACE In presenting this thesis, a word of acknowledgment to those who have helped to make this possible would not be inappropriate. I owe much to Professor G.F.A. Best for having initially interested me in the history of urban public health, for having encouraged me to write on this topic and for sparing no effort to help me, especially in the early stages. As Joint Supervisors, he and Professor H.W. Flinn have always been ready to encourage me, help me with useful ideas, ensure that my work was on the right lines and caution me when it was not. I owe much to Professor .Flinn, sole Supervisor latterly, for his useful and thorough advice as to the production of the contents and as to the form of the finished work. I am indebted also to other members of staff of this University of Edinburgh, too numerous to mention individually, for being ready to direct me to appropriate sources and to give me useful ideas. The collation of information on ,this subject has involved consultation of material at a number of institutions in Edinburgh. I have consulted the bulk of my local material in the Edinburgh Room of the Central Public Library where Mrs. Armstrong and her staff have been ready to go to any . trouble to search for material on my behalf and, over a long period, have given me every facility for study. Likewise, I have to thank Miss Armet, who was Archivist in the Edinburgh City Chambers while I was consulting material there. She went to much trouble to search out material I Whs j anxious to read; she was ready to elucidate me over difficult points and to help me in every manner possible. I must also thank the staff of the Edinburgh University Library for the ideal facilities given me for study, and for their expert help when I have been unable to find a book. I am indebted to various distinguished local public health experts for sparing the time and trouble to suggest to me useful material, offer PREFACE (cont'd.) guidance, and for the interest they have displayed in my work. Professor Brotherston of the Scottish Home and Health Department, Dr. Cameron of the Usher Institute of Public Health in tfarrender Park Rd., and Dr. Tait, Deputy M.O.H. for Edinburgh, have to be thanked. Dr. Tait must also be thanked for having so willingly allowed me facilities to study in his office in Johnston Terrace and for having lent me the use of some valuable sources. The thesis could not have been presented in this form had it not been for the expert and painstaking manner in which His. Sheila Campbell has typed the final version from a difficult arid lengthy manuscript. For having typed an earlier woiking version of a large part of the thesis to a high degree of accuracy from the original version which was almost illegible with my annotations, I have to acknowledge my gratitude to two of my colleagues in the National Library of Scotland, Mrs. Jennifer Robson \ and Miss Anne Martin, for having given up so much of their spare time over a long period. Finally, as a member of staff of the above Library, I have been in an enviable position. Not only have I had easy access to a wealth of material, but I have also been able to use my daytime working room as a place for study and have had no problems of security about njf thesis, whether in manuscript or typescript version. For being in that privileged position, I am indebted to my colleagues in the Library. 1 CHAPTER 1 INTRODUCTION This thesis aims to trace the origins of a collective effort, on the part of the Edinburgh municipal bodies, to undertake sanitary- work with the conscious purpose of improving the public health situation, and aims to assess the degree of success achieved by the close of the period covered by this story. The study attempts to have two closely connected and fundamental features of public health in view, without which such a study would be meaningless. The sanitary legislation available for use in Edinburgh through the decades, set limits to what the municipal bodies were competent to do: the acquisition of new legislation revealed a consciousness of problems felt by the municipal bodies to be serious enough to require legis¬ lative treatment (or felt to have been inadequately dealt with by previous legislation). The contribution of Dr. Littlejohn, the M.O.H. for Edinburgh from 1862 to 1908, to the public health work of the Edinburgh municipal bodies requires examination, both as a commen¬ tary on his own characteristics and as a commentary on the public health organisation within which he worked.